| 摘要: |
| ［摘要］ 目的 评价加速康复外科（ERAS）理念在小儿先天性胆总管囊肿围手术期中的应用效果。方法 回顾性分析广西壮族自治区人民医院小儿外科2015年3月至2023年12月收治的103例先天性胆总管囊肿患儿的临床资料。根据是否应用ERAS理念分为对照组58例和观察组45例，两组均行腹腔镜胆总管囊肿根治性手术，围手术期对照组按传统外科观念管理，观察组按ERAS理念管理。比较两组术中、术后临床及检验指标。结果 两组性别、年龄、体质量及术前白细胞（WBC）、C反应蛋白（CRP）、血红蛋白（Hb）、白蛋白（ALB）、前白蛋白（PAB）比较差异无统计学意义（P>0.05）。观察组术后24 h的WBC、CRP和术后3 d的CRP低于对照组，差异有统计学意义（P<0.05），两组术后24 h的Hb和术后3 d的WBC、Hb比较差异无统计学意义（P>0.05），两组术后2周的WBC、CRP、Hb、ALB、PAB比较差异无统计学意义（P>0.05）。两组患儿均痊愈出院，术后30 d内无再入院者。两组手术时间、术中出血量比较差异无统计学意义（P>0.05）。与对照组相比，观察组患儿术后肠鸣音恢复时间较早，术后住院时间较短，住院费用较少，差异有统计学意义（P<0.05）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。观察组满意率显著高于对照组（P<0.05）。结论 ERAS理念在小儿先天性胆总管囊肿围手术期中的应用是安全、有效、可行的，有临床应用价值，值得进一步研究及推广。 |
| 关键词: 加速康复外科 腹腔镜 先天性胆总管囊肿 围手术期 |
| DOI：10.3969/j.issn.1674-3806.2025.06.08 |
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| Evaluation of effectiveness of applying the concept of enhanced recovery after surgery in perioperative period of pediatric congenital choledochal cysts |
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WANG Wenmei, DENG Hongqiang, XIONG Quanqing, YANG Bowen, XIE Danlu, LI Liqin, WU Ling, PAN Yun, LIU Xing, ZHAO Qi
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Department of Pediatric Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the effectiveness of applying the concept of enhanced recovery after surgery(ERAS) in perioperative period of pediatric congenital choledochal cysts. Methods A retrospective analysis was conducted on the clinical data of 103 pediatric patients with congenital choledochal cysts who were admitted to Department of Pediatric Surgery, the People′s Hospital of Guangxi Zhuang Autonomous Region from March 2015 to December 2023. According to whether the concept of ERAS was applied to these patients, they were divided into control group(58 patients) and observation group(45 patients). Both groups underwent laparoscopic radical surgery for choledochal cysts. The control group was managed according to traditional surgical concept and the observation group was managed according to ERAS concept in the perioperative period. The clinical and laboratory indicators during and after the operation were compared between the two groups. Results There were no statistically significant differences in gender, age, weight, preoperative white blood cell count(WBC), C-reactive protein(CRP), hemoglobin(Hb), albumin(ALB) and prealbumin(PAB) between the two groups(P>0.05). The levels of WBC and CRP at 24 hours after operation and the level of CRP at 3 days after operation in the observation group were significantly lower than those in the control group(P<0.05). There were no statistically significant differences in the level of Hb at 24 hours after operation and in the levels of WBC and Hb at 3 days after operation between the two groups(P>0.05). There were no statistically significant differences in the levels of WBC, CRP, Hb, ALB and PAB at 2 weeks after operation between the two groups(P>0.05). The pediatric patients in both groups were cured and discharged from the hospital. None of these patients were readmitted to hospital within 30 days after the operation. There were no significant differences in the duration of operation and intraoperative blood loss between the two groups(P>0.05). Compared with the pediatric patients in the control group, the pediatric patients in the observation group had earlier recovery time of bowel sounds and shorter hospital stay after operation, and less hospitalization expenses, with statistically significant differences(P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05). The satisfaction rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion The application of the ERAS concept is safe, effective and feasible in the perioperative period of pediatric congenital choledochal cysts. It has clinical application value and is worthy of further research and promotion in clinical practice. |
| Key words: Enhanced recovery after surgery(ERAS) Laparoscope Congenital choledochal cysts Perioperative period |
